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Hip Incision Used by Dr. Loniewski:

Some patients will call about what type of incision or approach used for hip replacements. Most of these calls come from patients who were told by another friend or family member that there is a newer, less invasive approach from the front or anterior aspect of the hip. Here are some facts about this anterior or front approach:

The anterior approach is not new. Many orthopedic surgeons used a similar longer incision called the Smith-Peterson approach over the same area in the 1960’s and 1970’s but abandoned it due to an increase in complications.

The anterior approach is not without potential complications associated just with the incision choice alone. This includes increased blood loss; nerve damage and loss of sensation over your thigh; and a higher fracture rate of the femur.

The anterior approach normally requires the use of intra-operative x-rays exposing the patient and the staff to increased risk.

There is normally a greater length of time required, and a higher incidence of need for blood transfusions during this longer and bloodier surgery.

Studies comparing most of the popular surgical approaches has shown no difference in function, pain or outcome 6 weeks after the surgery.

Dr. Loniewski normally use a hybrid incision for total hips with a proven track record and an excellent safety record. This utilizes the benefits of an anterior approach, but with a better safety profile.

Dr. Loniewski use a minimally invasive anterior-lateral approach. This mini incision allows the surgeon to enter into the hip with minimal damage to any muscles or tendons. There is no use of skin staples or removable sutures. This is a plastic surgery type of closure. It also allows complete access a larger area of the hip allowing for proper visualization of the important parts of a hip replacement. The result of this improved visualization and lower surgical time is a lower rate of complications such as fractures of the bone, nerve damage, and bleeding. The anterior-lateral approach allows for a quicker operative time and no need for x-ray radiation. Many of our patients get up and walk the same day of surgery and an overwhelming majority of our patients are able to be discharged one day after surgery to the care of their families. In addition to this minimally invasive approach without any visible sutures or staples, Dr. Loniewski uses the patient’s own stem cells to heal the wound quicker and reduce the chances of infection. Bone marrow is aspirated at the same time of the surgery and this is concentrated down into a special paste used at the time of closure to promote healing, and reduce complications.